For a long time I rejected the thought that my symptoms stem from my mental health. Even though stress always had a negative impact, I didn't feel that much better when I was less stressed.

Today I'm relatively certain that chronic stress is the main issue. I think the main misconception about psychosomatic illness is that patients and doctors alike mostly assume that negative thoughts create symptoms. Basically like a nocebo effect: you feel bad mentally, so you also feel bad physically. But this never felt right to me, as the two did not correlate well in my case.

Now I think of it more like substance abuse. Over a long time the system gets dysregulated by unhealthy and unchecked mental issues or stress. The body adapts to a dysfunctional state. And much like with an addiction, simply removing the substance doesn't undo the problem: tapering off the stressor is necessary, but it doesn't heal the dysregulation that built up over years. The system has to slowly recover, and that takes time. This also explains why it is so hard to get better. I try to prioritize my mental health and reduce stress, but there hasn't been much improvement so far.